Provider Demographics
NPI:1477847291
Name:SIROVTECH
Entity Type:Organization
Organization Name:SIROVTECH
Other - Org Name:SIROV, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHECUNYA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-765-9318
Mailing Address - Street 1:8777B PINEY ORCHARD PKWY
Mailing Address - Street 2:SUITE 196
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-2245
Mailing Address - Country:US
Mailing Address - Phone:888-830-0831
Mailing Address - Fax:
Practice Address - Street 1:8777B PINEY ORCHARD PKWY
Practice Address - Street 2:SUITE 196
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-2245
Practice Address - Country:US
Practice Address - Phone:888-830-0831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14456251332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment